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Individual and regional determinants of long-term care expenditure in Japan: evidence from national long-term care claims

BACKGROUND: Japan, with the oldest population in the world, faces a financial challenge caused by rising long-term care (LTC) expenditure. For policymakers to address this, it is important that we have a better understanding of how individual and regional characteristics affect LTC expenditure. METH...

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Autores principales: Jin, Xueying, Mori, Takahiro, Sato, Mikiya, Watanabe, Taeko, Noguchi, Haruko, Tamiya, Nanako
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536255/
https://www.ncbi.nlm.nih.gov/pubmed/32556192
http://dx.doi.org/10.1093/eurpub/ckaa065
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author Jin, Xueying
Mori, Takahiro
Sato, Mikiya
Watanabe, Taeko
Noguchi, Haruko
Tamiya, Nanako
author_facet Jin, Xueying
Mori, Takahiro
Sato, Mikiya
Watanabe, Taeko
Noguchi, Haruko
Tamiya, Nanako
author_sort Jin, Xueying
collection PubMed
description BACKGROUND: Japan, with the oldest population in the world, faces a financial challenge caused by rising long-term care (LTC) expenditure. For policymakers to address this, it is important that we have a better understanding of how individual and regional characteristics affect LTC expenditure. METHODS: We linked national LTC insurance (LTCI) claim data, covering the entire population who used LTCI services in Japan, with municipality data on an individual level. Individuals 65 years and older (n=3 876 068) who had used LTCI benefits at least once in the fiscal year (FY) 2016 were included. We examined the associations of individual and municipality characteristics regarding supply and demand of healthcare with the LTC expenditures on facility care, home and community care, and total care (the sum of both types of care), after adjusting for regional differences in LTC extra charges. RESULTS: The following variables were associated with higher total expenditure; at the individual level: female, a higher care-need level, a lower income (0% co-payments) or a facility service user; at the municipality level: municipalities locating in metropolitan areas, with a higher proportion of single elderly households, more doctors per 1000 citizens, more nursing homes per 100 000 LTC benefit users or more outpatient medical spending per citizen ≥75 years old. CONCLUSIONS: As we are able to identify several individual and municipality characteristics associated with higher LTC expenditure in Japan, the study offers insights into dealing with the rapidly growing LTC expenditure.
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spelling pubmed-75362552020-10-13 Individual and regional determinants of long-term care expenditure in Japan: evidence from national long-term care claims Jin, Xueying Mori, Takahiro Sato, Mikiya Watanabe, Taeko Noguchi, Haruko Tamiya, Nanako Eur J Public Health Health Services Research BACKGROUND: Japan, with the oldest population in the world, faces a financial challenge caused by rising long-term care (LTC) expenditure. For policymakers to address this, it is important that we have a better understanding of how individual and regional characteristics affect LTC expenditure. METHODS: We linked national LTC insurance (LTCI) claim data, covering the entire population who used LTCI services in Japan, with municipality data on an individual level. Individuals 65 years and older (n=3 876 068) who had used LTCI benefits at least once in the fiscal year (FY) 2016 were included. We examined the associations of individual and municipality characteristics regarding supply and demand of healthcare with the LTC expenditures on facility care, home and community care, and total care (the sum of both types of care), after adjusting for regional differences in LTC extra charges. RESULTS: The following variables were associated with higher total expenditure; at the individual level: female, a higher care-need level, a lower income (0% co-payments) or a facility service user; at the municipality level: municipalities locating in metropolitan areas, with a higher proportion of single elderly households, more doctors per 1000 citizens, more nursing homes per 100 000 LTC benefit users or more outpatient medical spending per citizen ≥75 years old. CONCLUSIONS: As we are able to identify several individual and municipality characteristics associated with higher LTC expenditure in Japan, the study offers insights into dealing with the rapidly growing LTC expenditure. Oxford University Press 2020-06-18 /pmc/articles/PMC7536255/ /pubmed/32556192 http://dx.doi.org/10.1093/eurpub/ckaa065 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Health Services Research
Jin, Xueying
Mori, Takahiro
Sato, Mikiya
Watanabe, Taeko
Noguchi, Haruko
Tamiya, Nanako
Individual and regional determinants of long-term care expenditure in Japan: evidence from national long-term care claims
title Individual and regional determinants of long-term care expenditure in Japan: evidence from national long-term care claims
title_full Individual and regional determinants of long-term care expenditure in Japan: evidence from national long-term care claims
title_fullStr Individual and regional determinants of long-term care expenditure in Japan: evidence from national long-term care claims
title_full_unstemmed Individual and regional determinants of long-term care expenditure in Japan: evidence from national long-term care claims
title_short Individual and regional determinants of long-term care expenditure in Japan: evidence from national long-term care claims
title_sort individual and regional determinants of long-term care expenditure in japan: evidence from national long-term care claims
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536255/
https://www.ncbi.nlm.nih.gov/pubmed/32556192
http://dx.doi.org/10.1093/eurpub/ckaa065
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